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Feasibility and impact of a geriatrician-led liaison service for

older people admitted as an emergency under general surgery.



A. Vilches-Moraga


, J. Fox, A. Gomez-Quintanilla


, D. Copeland



J. Mort


, K. Wardle


, E. Feilding


, Z. Alio




Ageing and Complex Medicine,

Salford Royal NHS Foundation Trust, Manchester, United Kingdom


Increasing numbers of older people undergo emergency

hospitalisation and surgery. Comprehensive multidisciplinary has

proven its value in orthopaedics and vascular surgery.


This prospective study describes patient characteristics

and the impact of a geriatrician-led liaison service for older people

admitted non-electively to general surgery. We provided daily case

finding, multidisciplinary assessment, patient tailored interventions

and discharge planning.


Between 9th September 2014 and 30th November 2015 the

liaison service reviewed 300 patients. Seventy individuals (23.3%)

underwent surgery, 82 (27.3%) a non-surgical procedure, and 148

(49.3%) were managed non-invasively.

Mean age was 82.5 years (70

98), 61.3%

80 and 55.7% female. Most

individuals lived in their own home (90.7%), were independent in basic

(77.5%) and instrumental (52.5%) activities of daily living. 46.3%

mobilised with no walking aids or using a stick.

Multimorbidity (5.2 chronic conditions on average, and 96%

2) and

polypharmacy (8.6 medications on average and 41.4% taking

10 at

presentation) were the norm. Liver and biliary conditions (23%) and

cancer (19.3%) were the most common diagnoses. Median and mean

length of stay were 8 days and 13 days (1


30-day readmission rate was 14.3% (40/279). Mortality rates in

hospital, 30-days after hospital admission, 30-days after surgery and

30-days post-discharge were 7% (21/300), 8.7% (26/300), 8.6% (6/70)

and 5.4% (15/279) respectively.


Older individuals admitted non-electively under general

surgery often have cognitive or functional impairment and complex

social issues. A geriatrician-led liaison service facilitates recognition of

complications, enhances management of multimorbidity and poly-

pharmacy and drives discharge planning.


Prognostic factors in non-cardiac surgery in elders

J.C. Viveros García, J.L. Torres Gutiérrez, C.A. Moreno.

Hospital Regional

del ISSSTE, León, Guanajuato, México


Demographic transition have increased the number of

elders who develop surgical need. There is few evidence among

prognostic factors in the perioperative period in elders. Objetive: Find

factors associated to complicagtions in the posoperative period among

elder patients who underwent non-cardiac surgery.


Observational, descriptive, prospective trial which included

patients 65 years and older who underwent non cardiac surgery.

Data were taken from the patient

s file. Inclusión criteria: patients 65

years or older who underwent non cardiac surgery. Exclusion criteria:

ambulatory procedures and discharge before 24 hrs. We measured the

baseline characteristics of the patients: age, gender, tipe of surgery,

acute renal failure, vasoactive medications, current medications,

laboratory results and geriatric syndromes. The main outcome was

to identify factors associated to morbimortality in the posoperative

period. Stadystical Analysis: Software SPSS. Cuantitative variables

were analized by T Student, cualitative variables were analized by chi

square test.


Between july 2013 and june 2014 we included 100 patients

65 years and older who undergent non cardiac surgery. The mean

age was 78.5 years old. 47.5% were scheduled procedures. The mean

length of stay was 11.3 days, the patients of the neurosurgery

department stayed longer. Acute kidney injury, depression, falls, sore

ulcers and incontinency were associated with poor prognosis.

The main complications were delirium, and pneumonia.


The elderly patient often needs surgery, scheduled or

urgent. Most issues related to a poor prognosis may be corrected or

prevented. Age is not related to a poor prognosis in elderly surgery



Hemodynamic, geriatric and quality of life assessment after aortic

valve replacement in an old population hospitalized in Liege

University Hospital Belgium

S. Allepaerts


, S. Wislez


, S. Bruls


, M. Radermecker


, P. Lancellotti



J. Petermans




Geriatric Department, Liège University Hospital,


Cardiovascular Surgery Department, Liège University Hospital,


Cardiology Department, Liège University Hospital, Liège, Belgium


Surgical aortic valve replacement (SAVR) remains the

standard treatment of symptomatic aortic stenosis, though transcath-

eter AVR is indicated in non suitable surgical candidates. Risk of

morbidity and mortality are satisfactory in aging subjects. Few data are

available concerning the quality of life in the long-term after AVR.


We performed a retrospective study on 108 patients (age:

79 ± 5 years) who underwent surgical AVR or combined with coronary

artery bypass between January 2001 and December 2006. In 2012

(6.6 ± 1.4 years after surgery), an echocardiography, a comprehensive

geriatric assessment (CGA), an evaluation of quality of life were



30-day mortality was 9.2%. Survival at 1, 3, 5-year was 83%,

69.6%, 55.1%. Renal (p = 0.011) and respiratory (p = 0.005) failure,

stroke (p = 0.031) and delirium (p = 0.002) increased the risk of early

death. Pre and post surgery hemodynamic values showed a drop in

mean aortic pressure gradients (p < 0.0001), an increase of effective

orifice area (p < 0,0001). 67% of patient still living at home. The average

Mini Mental State was 25.6 ± 4.2, 20% had a risk of malnutrition, and

10% had a suspicion of depression. 40% of the patients had fallen

within 6 months. Quality of life was worse for physical activity and

perceived health, better for limitations due to psychic state, physical

pain, vitality and relationship, and similar on the limitations due to

physical state and mental health.


Surgical AVR in elderly patients with aortic stenosis can

be performed with an acceptable mortality. Both long-term functional

recovery and quality of life appear reasonable.

Area: Psychiatric symptoms and illnesses


Psychotropic medication reconciliation: considering

orthogeriatric unit admission a chance of therapeutic switch

A. González Ramírez, R. Pérez López, M.M. Luis, C. Pablos Hernández,

J.M. Julián Enríquez, J.F. Blanco Blanco.

Universitary Hospital of



The geriatric patient is particularly susceptible to

serious side effects (falls, delirium, daily somnolence) of psychotropics

(benzodiazepines, hypnotics, neuroleptics). Therefore, its withdrawal

could possibly improve their quality of life. When considering

psychotropic withdrawal, trazodone presents an ubiquitary action

and a safe profile.


To implement a psychotropic prescription withdrawal by

alternative prescription of trazodone in an Orthogeriatric Unit during

hip fracture perioperative period.

Material and methods:

Retrospective observational descriptive study.

Population: 65-year-old patients or older with hip fracture consecu-

tively admitted in an Orthogeriatric Unit (June 2015

May 2016).

Inclusion criteria: on >3 month psychotropic treatment, eventual

psychotropic side effects. Source: Medora


, Farmatools


, anamnesis

and global geriatric assessment file. Database and statistical analysis:




Poster presentations / European Geriatric Medicine 7S1 (2016) S29